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General NPI Number Information
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NPI Number | 1265754527
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Entity Type | Organization
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Legal Business Name | NEUROLOGICAL ASSOCIATES OF THE FOUR STATES
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 3125 DR RUSSELL SMITH WAY
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City | CARTHAGE
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State | MO
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Zip | 64836-7402
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Country | US
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Telephone | 417-359-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 RUSTIC RDG
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City | JOPLIN
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State | MO
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Zip | 64804-3680
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Country | US
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Telephone | 417-627-9596
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Fax |
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Authorized Official
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Title or Position | NEUROLOGIST
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Name | DR. CHRISTOPHER ROBERT ANDREW
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Credential | M.D.
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Telephone | 417-627-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 100303
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License Number State | MO
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